Abstract
In all, 290 femoral to above-knee popliteal artery bypasses were performed between January 1983 and September 1991. PTFE grafts were used in 113 cases (39%) and vein grafts in 177 (61%) (reversed in 146 cases and in situ in 31). Patients were followed up for a median time of 20 months. The 2-, 4- and 6-year patency rates for vein and PTFE grafts were 70%, 62% and 57%, respectively, compared with 58%, 46% and 41% (no statistical difference in survival curves, P = 0.2). The 2-, 4- and 6-year limb salvage rates were 82%, 78% and 62% compared with 75%, 64% and 58% (no statistical difference in survival curves, P = 0.6). A total of 99 grafts occluded during follow-up (45 PTFE and 54 vein grafts). Major amputation was required in 63 limbs; below-knee in 37 limbs (59%), and above-knee in 26 limbs (41%). There was no statistical difference in the amputation level with respect to the graft type. Final healing at the below-knee level was achieved in 23 of 35 (66%) failed vein grafts and in 14 of 28 (50%) failed PTFE grafts.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Dardik H., Kahn M., Dardik I., Sussman B., Ibrahim I. M. Influence of failed vascular bypass procedures on conversion of below-knee to above-knee amputation levels. Surgery. 1982 Jan;91(1):64–69. [PubMed] [Google Scholar]
- Hasson J. E., Megerman J., Abbott W. M. Increased compliance near vascular anastomoses. J Vasc Surg. 1985 May;2(3):419–423. [PubMed] [Google Scholar]
- Hobson R. W., 2nd, Lynch T. G., Jamil Z., Karanfilian R. G., Lee B. C., Padberg F. T., Jr, Long J. B. Results of revascularization and amputation in severe lower extremity ischemia: a five-year clinical experience. J Vasc Surg. 1985 Jan;2(1):174–185. doi: 10.1067/mva.1985.avs0020174. [DOI] [PubMed] [Google Scholar]
- Imparato A. M., Bracco A., Kim G. E., Zeff R. Intimal and neointimal fibrous proliferation causing failure of arterial reconstructions. Surgery. 1972 Dec;72(6):1007–1017. [PubMed] [Google Scholar]
- Johansen K., Zorn R. Amputation stump infection in patients with retained thrombosed prosthetic vascular grafts. Am Surg. 1981 May;47(5):228–231. [PubMed] [Google Scholar]
- Johnson J. A., Cogbill T. H., Strutt P. J., Gundersen A. L. Wound complications after infrainguinal bypass. Classification, predisposing factors, and management. Arch Surg. 1988 Jul;123(7):859–862. doi: 10.1001/archsurg.1988.01400310073012. [DOI] [PubMed] [Google Scholar]
- Kazmers M., Satiani B., Evans W. E. Amputation level following unsuccessful distal limb salvage operations. Surgery. 1980 Jun;87(6):683–687. [PubMed] [Google Scholar]
- Michaels J. A. Choice of material for above-knee femoropopliteal bypass graft. Br J Surg. 1989 Jan;76(1):7–14. doi: 10.1002/bjs.1800760105. [DOI] [PubMed] [Google Scholar]
- Rubin J. R., Marmen C., Rhodes R. S. Management of failed prosthetic grafts at the time of major lower extremity amputation. J Vasc Surg. 1988 May;7(5):673–676. [PubMed] [Google Scholar]
- Szilagyi D. E. Observations on autogenous vein grafts used as arterial substitutes. Bull Soc Int Chir. 1974 Jul-Aug;33(4):302–314. [PubMed] [Google Scholar]
- Veith F. J., Gupta S. K., Ascer E., White-Flores S., Samson R. H., Scher L. A., Towne J. B., Bernhard V. M., Bonier P., Flinn W. R. Six-year prospective multicenter randomized comparison of autologous saphenous vein and expanded polytetrafluoroethylene grafts in infrainguinal arterial reconstructions. J Vasc Surg. 1986 Jan;3(1):104–114. doi: 10.1067/mva.1986.avs0030104. [DOI] [PubMed] [Google Scholar]
- Whittemore A. D., Kent K. C., Donaldson M. C., Couch N. P., Mannick J. A. What is the proper role of polytetrafluoroethylene grafts in infrainguinal reconstruction? J Vasc Surg. 1989 Sep;10(3):299–305. doi: 10.1067/mva.1989.14116. [DOI] [PubMed] [Google Scholar]